Supreme Court rules seafarer entitled to benefits as company doctor stated illness is "likely" work-related; discusses principles of work-relation and work-aggravation in disability compensation cases
 
 
Seaman was engaged as Fitter. During employment, he noticed a swelling on his neck. He was repatriated and placed under the care of the company-designated physician where he was diagnosed with nasopharyngeal carcinoma. Eventually, the company-designated physician issued an opinion that respondent's illness is likely not work-related but he indicated that risk factors for such illness are  diet-salt cured fish, viral agents - Eipstein Barr virus and genetic susceptibility that could have contributed to seaman's condition.  The seaman demanded payment of full disability benefits which was denied by the company on the ground that the illness is not work-related.
 
A complaint was filed by the seaman before the Labor Arbiter who ruled in his favor and awarded USD60,000.00 disability benefits. It ruled that there existed a causal relationship between seaman's cancer and his diet on board the vessel and that the company failed to overcome the presumption of work-relatedness of the illness.
 
The NLRC affirmed the ruling of the Labor Arbiter and held that seafarer had no choice but to eat the food prepared by the kitchen staff and correlatively his diet was limited to salt-cured foods such as salted fish, dried meat, salted egg, frozen meat and other preserved goods, all of which allegedly increase the risk of contracting nasopharyngeal cancer.
 
The Court of Appeals affirmed the ruling of the NLRC.
 
The Supreme Court awarded disability benefits.
 
Two principles were considered in this case: (1) The principle of work-relation and (2) The principle of work-aggravation.
 
 
The Principle of Work-Relation
 
Under the POEA Contract, the injury or illness must be work-related and must have existed during the term of the seafarer's employment in order for compensability to arise.  Work-relation must, therefore, be established.
 
As a general rule, the principle of work-relation requires that the disease in question must be one of those listed as an occupational disease under Sec. 32-A of the POEA-SEC. Nevertheless, should it be not classified as occupational in nature, Section 20 (B) paragraph 4 of the POEA-SEC provides that such diseases are disputably presumed as work-related.
 
In this case, the illness of the seaman is not listed as an occupational disease, and as such, it has the disputable presumption of being work-related. This presumption works in the seafarer's favor. Hence, unless contrary evidence is presented by the employers, the work-relatedness of the disease must be sustained.
 
The medical report issued by the company-designated doctor failed to make a categorical statement confirming the total absence of work relation when it stated that "His condition is likely not work-related." The use of the word likely indicates a hesitant and an uncertain tone in the stated medical opinion and does not foreclose the possibility that seaman's illness could be work-related. In other words, as the doctor opined only a probability, there was no certainty that his condition was not work related. There being no certainty, the presumption of the illness being work-relatedness was affirmed by the Court.
 
 
The Principle of Work-Aggravation
 
Compensability may also be established on the basis of the theory of work aggravation if by substantial evidence, it can be demonstrated that the working conditions aggravated or at least contributed in the advancement of the illness.
 
The argument of the seaman is that high risk dietary foods, to which his meals were limited, on-board the vessel increased the possibility that the disease was aggravated by his working conditions.  The Court did not agree to this allegation as it was not substantiated by evidence.  Although the Court has recognized as sufficient that work conditions are proven to have contributed even to a small degree, such must, however, be reasonable, and anchored on credible information.  The seaman must, therefore, prove a fact other than by his mere allegations.
 
The Court refused to take judicial notice of seaman's argument that it is common knowledge that the food or seafarers are limited to what is served them which consists of salt-cured food, frozen and processed meat and preserved food. This is in light of the changing global landscape affecting international maritime labor practices. The Court notes the acceptance of the minimum standards governing food and catering on board ocean-going vessels as provided in the 2006 Maritime Labor Convention of which the Philippines and the flag country of the vessel are signatories.
 
Although not yet fully implemented, the 2006 MLC merely underscores that food on board an ocean-going vessel may not necessarily be limited as alleged by the seaman. In this respect, the company submitted documents showing that fresh and varied provisions were provided on board.  As such, the seaman cannot claim on the basis of the principle of work-aggravation.
 
The Supreme Court held further:
 
Based on the foregoing, both parties failed to discharge their respective burdens to prove the non-work-relatedness of the disease for the company (theory of work-relation) and the substantiation of claims for the seaman (theory of work-aggravation).  With this, the Court is confronted with the question as to whom it should rule in favor then.
 
The Court held that disability should be understood not more on its medical significance, but on the loss of earning capacity. Permanent total disability means disablement of an employee to earn wages in the same kind of work or work of similar nature that he was trained for or accustomed to perform, or any kind of work which a person of his mentality and attainment could do. It does not mean absolute helplessness. Evidence of this condition can be found in a certification of fitness/unfitness to work issued by the company-designated physician.
 
In this case, records reveal that the medical report issued by the company-designated oncologist was bereft of any certification that respondent remained fit to work as a seafarer despite his illness. This is important since the certification is the document that contains the assessment of his disability which can be questioned in case of disagreement as provided for under Section 20 (B) (3).of the POEA-SEC.
 
In the absence of any certification, the law presumes that the employee remains in a state of temporary disability. Should no certification be issued within the 240 day maximum period, as in this case, the pertinent disability becomes permanent in nature.
 
When doubts exist, the scales of justice must tilt in the seaman's favor.
 
 
Author's Note:  It appears that the decision rendered by the Supreme Court is different from the previous decisions rendered in the cases of Magsaysay Maritime Corp. v. NLRC and Rommel Cedol, G.R. No. 186180, March 22, 2010, Quizora v. Denholm Crew Management Phils., Inc., G.R. No. 185412, November 16, 2011 and Sea Power Shipping Ent., Inc. v. Salazar, G.R. No. 188595, August 28, 2013 where compensation were denied and it was held that the disputable presumption provision in the POEA Contract does not allow the seafarer to just sit down and wait for the company to present evidence to overcome the disputable presumption of work-relatedness of the illness. In said cases, the Court said that the seafarer still has to substantiate his claim in order to be entitled to disability compensation. He has to prove that the illness he suffered was work-related and that it must have existed during the term of his employment contract. He cannot simply argue that the burden of proof belongs to the company.
 
Moreover, the issue in the above case is whether the seaman's illness is considered as work-related.  As such, the author humbly disagrees with the ruling of the Supreme Court when it based the award of disability benefits on the failure of the company-designated doctor to determine the fitness to work of the seaman within the period of 240 days.  Whether a seaman is disabled or not, the determining factor which must first be considered is work-relation of the illness.  If the illness is not work-related, then the seaman should not be entitled to disability benefits even if he is considered as permanently disabled.
 
In effect, in this case,  the Supreme Court reminds us that company doctors opinions on "work-relation" should be definite so as to avoid any doubt as otherwise, the Supreme Court will interpret such doubt in favour of the seafarer. Please note that in the Magsaysay vs. Cedol case, the doctor there made a definitive declaration that seafarer's cancer cannot be considered as work-related.